Seborrheic dermatitis is a common skin condition which affects mostly men. Based on its name, it is clear that the involved areas are those with severe seborrhea (scalp, face and upper torso). Clinically, dermatitis can manifest in several different ways. By non-inflammatory symptoms such as simple scaling without redness (eg dandruff) or by red plaques on the face and body covered with oily scales. The most severe variant of the disease is associated with the involvement of the entire body surface. Fortunately, it is rare.
What are the causes of seborrheic dermatitis?
eborrheic dermatitis is often associated with increased colonization of the fungus Malassezia, to which the body develops an abnormal immune response. The presence of seborrhea is not a direct cause of dermatitis, but rather provides a favorable environment for the reproduction of the fungus. In fact, seborrhea means increased production of sebum by the sebaceous glands. Another important pathogenetic factor is the change in cellular immunity. This is why dermatitis is more common in people with immunosuppressive conditions due to illness or concomitant therapy. Influence on the clinical course of the condition has the most clichéd, but believe me rightly mentioned reason - psycho-emotional stress. Many patients register work or family stress as an event chronologically coinciding with an exacerbation of seborrhea.
The prevalence of dermatitis is in localizations that are richest in sebaceous glands. This includes the scalp, ear canal, face in the T-zone, and upper torso. The clinical picture varies in different age groups. You can read more about seborrheic dermatitis in infants at this article. Symptoms in adults are characterized by redness in the area between the eyebrows, nasolabial folds, chin. They are covered with oily, yellowish scales and are usually intensely itchy. A more specific clinical manifestation is the involvement of the ear canal, eyelids or the border of the hair with the forehead, which bears the special name "seborrheic crown". A very unpleasant moment for men is the inflammation of the skin in the chin area after shaving. If possible, it is good for these gentlemen to avoid a razor, but to keep their beard with a clipper, which does not rub against the epidermis.
Most often, local remedies are sufficient to control the acute phase of dermatitis. The drugs used are from the group of antifungal and corticosteroid creams. Which cream to be first depends on the inflammatory component of the lesions. For severely reddened and itchy plaques, it is advisable to start with low- or medium-potent corticosteroid creams. Once the inflammatory phase has been mastered, you can move on to targeting Malassezia through azole creams. In severe seborrheic eczema, a systemic antifungal is used for at least a week. In the "bright" periods without symptoms, I recommend supportive medical cosmetics designed for seborrheic skin. Shampoos with zinc peritoneum, selenium sulfide, cyclopirox, etc. are suitable for the scalp.
- New research shows that a diet rich in fruits and vegetables is associated with less frequent exacerbations of the disease. The same goes if spicy and spicy food is excluded from the menu. The Western diet, about which you can read more here, is associated with a 47% increased risk of seborrheic dermatitis.
- Seborrhea in the scalp is very similar to psoriasis in this area. Seek a dermatologist for advice, as the therapy is different and requires the inclusion of other groups of medications.
Tucker D, Masood S. Seborrheic Dermatitis. 2020 Oct 3. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 31869171.